Diastereomers of 4-aryloxy-3-hydroxypiperidines

ABSTRACT

The present invention relates to essentially pure diastereomers of 4-aryloxy-3-hydroxypiperidines, including purified diastereomers of ifoxetine, methods of purifying said diastereomers, pharmaceutical compositions comprising said diastereomers and methods of treatment utilizing said pharmaceutical compositions.

This application claims the benefit of U.S. Ser. No. 60/502,157, filedSep. 10, 2003, herein incorporated by reference in its entirety.

FIELD OF THE INVENTION

The present invention relates to essentially pure diastereomers of4-aryloxy-3-hydroxypiperidines, including purified diastereomers ofifoxetine, methods of purifying said diastereomers, pharmaceuticalcompositions comprising said diastereomers and methods of treatmentutilizing said pharmaceutical compositions.

BACKGROUND OF THE INVENTION

Chemically ifoxetine is(+/−)-bis-[cis-3-hydroxy-4-(2,3-dimethyl-phenoxy)]-piperidine sulfate.According to the prior art, ifoxetine specifically and selectivelyblocks 5-HT reuptake in the brain without affecting the 5-HT uptakeprocesses in the periphery (blood platelets). See Delini-Stula et al.,Int Clin Psychopharmacol. 1987 July; 2 (3):201-15, herein incorporatedby reference in its entirety. The prior art also states that ifoxetinedisplays weak or no interactions with 5-HT₁, 5-HT₂, alpha₁, alpha₂,beta-noradrenoceptors, histamine H₁, muscarinic acetylcholine, opiate,GABA_(A), and benzodiazepine receptors in vitro, and with dopamine and5-HT₂ receptors in vivo. See Waldmeier et al., Eur J. Pharmacol. 1986Oct. 14;130(1-2):1-10, herein incorporated by reference in its entirety(“Waldmeier”).

The synthesis of ifoxetine is disclosed in U.S. Pat. No. 4,160,837(“Paioni”), herein incorporated by reference in its entirety.Specifically, Paioni disclosed that that certain4-aryloxy-3-hydroxypiperidines (1), where Ar is a substituted orunsubstituted aromatic hydrocarbon group and R is hydrogen or methyl,possess valuable pharmacological properties, and can be used for thetreatment of mental depression. See also Paioni and Waldmeier 1985,Proc. VIIth Int. Symp. Medicinal Chemistry (August 27-31, Uppsala,Sweden Vol. 2, eds. Dahlbom et al., Swedish Pharmaceutical Press,Stockholm, pp. 130-132, herein incorporated by reference in itsentirety.

Specific embodiments described in Paioni were thedimethylphenoxypiperidines which included compounds 2-5. (Ifoxetine isracemic composition comprising the two cis diastereomers of compound 2.)

Since each of compounds 2-5 contains chiral centers at carbon 3 andcarbon 4, the compounds comprise four possible diastereomers. Forexample the possible diastereomers of compound 2 comprise the followingisomers which are shown below: 2a, (3S,4R), 2b (3R,4S), 2 c (3R,4R) and2d (3S,4S).

According to Paioni and Waldmeier et al, see supra, stereochemistry haslittle effect on the activity of compound 2.

The following U.S. patents and publications describe methods,compositions, or compounds, which comprise ifoxetine. U.S. Pat. No.6,528,521, herein incorporated by reference in its entirety, describes amethod for treating sexual dysfunction that is caused by anti-depressantmedication in a patient in need of such treatment, comprisingadministering a therapeutically effective amount of apomorphine or apharmaceutically acceptable salt thereof, to said patient, is disclosed.The method may be utilized for patients taking anti-depressants such astricyclic anti-depressants, monamine oxidase inhibitors or serotoninselective reuptake inhibitors (SSRI). The serotonin selective reuptakeinhibitors may include ifoxetine.

U.S. Pat. No. 6,495,154, herein incorporated by reference in itsentirety, describes a method for delaying the onset of ejaculation in anindividual. The method involves systemic and on demand administration toan individual of a pharmaceutical formulation containing an amount of anactive agent selected from the group consisting of clomipramine andpharmacologically acceptable acid addition salts thereof. Drug deliverymay be accomplished via any route designed to provide systemic levels ofthe active agent effective to delay the onset of ejaculation.Pharmaceutical formulations and dosage forms are provided as well. Inone embodiment, the pharmaceutical formulation also comprises ifoxetine.

U.S. Pat. No. 6,403,597, herein incorporated by reference in itsentirety, describes a method for treatment of premature ejaculation byadministration of a phosphodiesterase inhibitor, e.g., an inhibitor of aType III, Type IV, or Type V phosphodiesterase. In a preferredembodiment, administration is on as “as needed” basis, i.e., the drug isadministered immediately or several hours prior to sexual activity.Pharmaceutical formulations and packaged kits are also provided. In oneembodiment, the pharmaceutical formulation also comprises ifoxetine.

U.S. Pat. Nos. 6,331,289, 6,264,917 and 6,261,537, herein incorporatedby reference in their entirety, disclose targetable diagnostic and/ortherapeutically active agents, e.g. ultrasound contrast agents,comprising a suspension in an aqueous carrier liquid of a reportercomprising gas-containing or gas-generating material, said agent beingcapable of forming at least two types of binding pairs with a target.The disclosed compositions and methods may further comprise ifoxetine.

U.S. Pat. No. 6,303,595, herein incorporated by reference in itsentirety, describes a method for treating sleep apneas utilizingmirtazapine. Optionally, mirtazapine is combined with an SSRI such asfluoxetine or ifoxetine.

U.S. Pat. Nos. 6,228,864 and 5,922,341, herein incorporated by referencein their entirety, describes methods for delaying the onset ofejaculation in an individual. The methods preferably involveadministration of an antidepressant drug, a serotonin agonist orantagonist, an adrenergic agonist or antagonist, an adrenergic neuroneblocker, or a derivative analog thereof, within the context of aneffective dosing regimen. The preferred mode of administration istransurethral; however, the selected active agent may also be deliveredvia intracavernosal injection or using alternative routes.Pharmaceutical formulations and kits are provided as well.

U.S. Pat. No. 5,977,099, herein incorporated by reference in itsentirety, describes a pharmaceutical composition comprising mirtazapine,a SSRI and pharmaceutically acceptable auxiliaries. In particular theSSRI is selected from fluoxetine, fluvoxamine, citalopram, cericlamine,femoxetine, sertraline, paroxetine, ifoxetine, cyanodothiepin andlitoxetine. The composition, which can be used to treat depressantpatients has less side effects than treatment of the patients withmirtazapine or the SSRI alone.

EP Patent No. 835660, herein incorporated by reference in its entirety,describes products containing methylcobalamin in an overdosecorresponding to a weekly intramuscular dose higher than 1000micrograms, preferably higher than 1200 micrograms and correspondingmore preferably to a weekly intramuscular dose of at least 1500micrograms, and an antidepressant enhancing the serotonin level as acombined preparation for simultaneous, separate or sequential use in thetreatment of multiple sclerosis or other demyelinating conditions. Inone embodiment the 1 product comprises ifoxetine.

International application WO9200103, herein incorporated by reference inits entirety, describes a pharmaceutical product comprising two or threeactive ingredients as a combined preparation for simultaneous, separateor sequential use in therapy of depression and/or migraine. In oneembodiment the pharmaceutical product comprises ifoxetine.

International application WO9200103, herein incorporated by reference inits entirety, describes prodrugs of antidepressants and the use of theseprodrugs in a method for therapy and to pharmaceutical compositionscomprising the prodrugs of the invention.

SUMMARY OF THE INVENTION

The present invention provides for compounds, which are essentially purediastereomers of 4-aryloxy-3-hydroxypiperidines (1) or an addition saltthereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

In a further embodiment the present invention provides forpharmaceutical compositions which comprise a pharmaceutically acceptablecarrier and a compound, wherein the compound is an essentially purediastereomers of a 4-aryloxy-3-hydroxypiperidines (1) or an additionsalt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

In a further embodiment the present invention provides for a method oftreating afflictions of the central and peripheral nervous systems byadministering pharmaceutical composition which comprise apharmaceutically acceptable carrier and a compound, wherein thecompounds is an essentially pure diastereomers of a4-aryloxy-3-hydroxypiperidines (1) or an addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

In a further embodiment the present invention provides for a method ofbinding 5-HT receptors in an animal by the administration to an animalof a pharmaceutical composition comprising a pharmaceutically acceptablecarrier and a compound, wherein the compound is an essentially purediastereomers of a 4-aryloxy-3-hydroxypiperidines (1) or an additionsalt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

In a further embodiment the present invention provides for a method ofpurification of an essentially pure diastereomer of a4-aryloxy-3-hydroxypiperidines (1) or an addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and the chiral center at carbon 4 is either in the R orthe S configuration.

In a further embodiment the present invention provides for essentiallypure (3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for essentiallypure (3S,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for essentiallypure (3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for essentiallypure (3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure(3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition saltthereof and a pharmaceutically acceptable carrier.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure (3S,4R),-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition salt thereofand a pharmaceutically acceptable carrier.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure(3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition saltthereof and a pharmaceutically acceptable carrier.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure(3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition saltthereof and a pharmaceutically acceptable carrier.

DETAILED DESCRIPTION OF THE INVENTION

We have now unexpectedly found that there are significant differencesbetween the diastereomers of 4-aryloxy-3-hydroxypiperidines of formula(1), in their interactions with certain pharmacologically significantprotein receptor sites.

As used herein the cis racemic composition refers to an unresolvedmixture of cis diastereomers. As used herein the trans racemiccomposition refers to an unresolved mixture of trans diastereomers.

As used herein an “essentially pure diastereomer” preferably refers to adiastereomer, which is greater than about 70% pure. More preferably,“essentially pure diastereomer” refers to a diastereomer, which isgreater than about 90% pure. Even more preferably, “essentially purediastereomer” refers to a diastereomer, which is greater than about 95%pure. Most preferably, “essentially pure diastereomer” refers to adiastereomer, which is greater than about 98% pure.

As used herein an “addition salt” preferably refers to a salt of acompound of formula I prepared by reaction of a compound of formula Iwith a mineral or organic acid. For exemplification of pharmaceuticalacid addition salts see, e.g., Berge, S. M, Bighley, L. D., andMonkhouse, D. C., J. Pharm. Sci., 66:1, 1977, incorporated by referencein its entirety. Acids commonly employed to form addition salts areinorganic acids such as hydrochloric acid, hydrobromic acid, hydroiodicacid, sulfuric acid, phosphoric acid, and the like, and organic acidssuch as p-toluenesulfonic, methanesulfonic acid, ethanesulfonic acid,oxalic acid, p-bromophenylsulfonic acid, carbonic acid, succinic acid,citric acid, tartaric acid, benzoic acid, acetic acid, and the like.

As used herein “pharmaceutically acceptable salts” include but are notlimited to, those derived from organic acids such as acetic acid, malicacid, tartaric acid, citric acid, lactic acid, succinic acid, fumaricacid, maleic acid, oxalic acid, benzoic acid, salicylic acid,phenylacetic acid, mandelic acid, methanesulfonic acid, benzenesulphonicacid and p-toluenesulfonic acid, mineral acids such as hydrochloric andsulfuric acid and the like.

Salts may be prepared in a conventional manner by methods well-known inthe art. The compounds of this invention may also exist in solvated orhydrated or polymorphic forms.

The synthesis of compositions comprising cis and trans racemate of4-aryloxy-3-hydroxypiperidines (1) has been described by Paioni.

Purified Diastereomers of the Invention

Accordingly, the present invention provides for compounds, which areessentially pure diastereomers of 4-aryloxy-3-hydroxypiperidines (1) oran addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

As used herein, “a substituted or unsubstituted aromatic hydrocarbongroup” preferably refers to a substituted or unsubstituted phenyl group.Preferably a substituted phenyl group is a mono, di or tri substitutedphenyl group.

Substituents of the phenyl group may be independently selected frompreferably C1 to C6 alkyl, C1 to C6 alkoxy, hydroxyl or halo groups.Preferably the substituents are methyl groups.

Most preferably, Ar is selected from the group consisting of2,3-dimethylphenyl and 3,4-dimethylphenyl.

Preferably, R is selected from the group consisting of hydrogen andmethyl.

In a further embodiment the present invention provides for essentiallypure (3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for essentiallypure (3S,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for essentiallypure (3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

In a further embodiment the present invention provides for essentiallypure (3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an additionsalt thereof.

Method of Purification

Paioni does not resolve the cis and trans racemic compositions into theindividual diastereomers.

Accordingly, a further embodiment the present invention provides for amethod of purification of an essentially pure diastereomers of a4-aryloxy-3-hydroxypiperidines (1) or an addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and the chiral center at carbon 4 is either in the R orthe S configuration.

Preferably, the essentially pure diastereomers are purified from a cisracemic composition or a trans racemic composition by columnchromatography. In a preferred embodiment the diastereomers are purifiedby HPLC. Preferably the stationary phase of the HPLC column comprises achiral column prepared by coating silica with a chiral molecule. Apreferred chiral molecule is chiral polymer such as amylose. Preferably,the hydroxyl groups on the amylose are functionalized by reacting withan isocyanate to give the corresponding carbamate. The chirality arisesfrom the stereogenic sites on the amylose rings. Commercially availablecolumns, which would be useful for purifying the diastereomers, includefor example, CHIRALPAK® AD™. Preferably, the mobile phase comprises apolar solvent or mixtures of polar solvents. Preferred polar solventsinclude water, acetonitrile, methanol, or ethanol or mixtures thereof.Most preferably the mobile phase is HPLC grade ethanol. As used herein,HPLC grade ethanol preferable refers to ethanol, which is greater thanabout 95% pure. More preferably, HPLC grade ethanol refers to ethanol,which is greater than about 97% pure. Most preferably, HPLC gradeethanol refers to ethanol, which is greater than about 98% pure.

The temperature of the HPLC column during purification may range fromabout 5 to about 40° C. Most preferably the temperature range is about20 to about 23° C. (ambient temperature).

Methods of Treatment

In a further embodiment the present invention provides for a method oftreating afflictions of the central and peripheral nervous systems byadministering a pharmaceutical compositions which comprise a compound,wherein the compound is an essentially pure diastereomer of a4-aryloxy-3-hydroxypiperidine (1) or an addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

In particular, compositions comprising essentially pure diastereomer ofthe present invention are expected to be an improvement on many existingtreatments for anxiety, depressive and related disorders in terms ofside effect profiles, ease of dosing, patient compliance and clinicalefficacy. Particular indications are for use of the essentially purediastereomer in the treatment of: all depressive symptoms and disordersincluding major depression, minor depression, atypical depression,recurrent depression, dysthymia, depressive phase of bipolar disorder,seasonal affective disorder. Also depressive symptoms and disordersassociated with other psychiatric, neurological or physical medicaldisorders, examples being, depression associated with schizophrenia,depression associated with dementia, depression associated with physicalconditions such as cancer. All anxiety symptoms and disorders includingpanic disorders, specific phobias, social phobia, social anxietydisorder, post-traumatic stress disorder (PTSD), obsessive-compulsivedisorder (OCD), generalized anxiety disorder (GAD). Also anxietysymptoms and disorders associated with other psychiatric, neurologicalor physical/medical disorders. Also psychiatric syndromes manifested inanimals, e.g., horses, cats and dogs.

Compositions comprising essentially pure diastereomer of the presentinvention are also expected to be an improvement on many existingtreatments for bipolar disorder, penile erectile dysfunction (PED),premature ejaculation, eating disorders such as anorexia nervosa (AN),binge disorder and bulimia nervosa (BN), premenstrual dysphoric disorder(PMDD), premenstrual syndrome, pathological gambling, irritable boweldisorder, female sexual dysfunction, inflammatory bowel disease, hotflushes associated with menopause, neuropathic pain, neuralgias,compulsive and obsessive behaviours including pathological shoppingdisorder, autism, somatic symptoms associated with psychiatricdisorders, e.g., non-specific chest pains, fibromyalgia, agitativesymptoms. Also treatment of alcohol abuse, smoking and other addictions.

In addition to their use as treatments (first-line or other) for theaforementioned disorders, the compounds of the present invention alsohold clinical promise for use in combination therapies in the treatmentof human and animal disease. In particular, the present inventionprovides for combination therapies of an essentially purifieddiastereomers of 4-aryloxy-3-hydroxypiperidine with other activeingredients. For example, in one embodiment the present inventionprovides for a combination therapy of an essentially purifieddiastereomers of 4-aryloxy-3-hydroxypiperidine with desensitisers of the5-HT1a autoreceptors, such as pindolol. It is contemplated thatcombination therapies may show a faster onset of antidepressant effects.

The present invention also provides for combination therapies with otheractive ingredients for the treatment of resistant or refractorydepressive, anxiety or bipolar disorders. Such active ingredientsinclude the anti-psychotics, anti-epileptics, other anti-depressants,other anxiolytics, benzodiazepines and mood stabilizers.

The present invention also provides for combination therapies with otherantidepressants and/or anxiolytics for the treatment of sub-optimallytreated disorders.

In a further embodiment the present invention provides for a method ofbinding 5-HT receptors in an animal by the administration to an animalof a pharmaceutical composition comprising a compound, wherein thecompound is an essentially pure diastereomers of a4-aryloxy-3-hydroxypiperidines (1) or an addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration.

The essentially pure diastereomers of the invention and theirpharmaceutically acceptable addition salts possess pharmacologicalactivity as can be shown in standard test methods, and are accordinglyindicated for use as pharmaceuticals. The compounds of the presentinvention have a range of pharmaceutical activities that ensure theywill provide a useful addition to the armamentarium of medicationsavailable for the treatment of human and animal disease. Their effectsare linked, but not always exclusively so, to serotoninergic (alsoreferred to though out this application as 5-HT) functions; theirinteractions at serotonin receptors show complex behavior in terms ofsub-type selectivity, agonist and antagonistic behavior and low and highdose mediated effects.

The selectivity of specific diastereomers of the claimed compoundstowards different enzymes and receptors is manifested, for example, inthe interaction of isolated essential pure diastereomers of compound 2with 5-HT receptor sub-types as shown below. As shown below theessentially pure diastereoiosomer of ifoxetine,(3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, is an effectiveinhibitor of binding to 5-HT_(1A), 5-HT_(2B), and 5-HT_(2c), receptors.It was also found that the essentially pure diastereoiosomer,(3S,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, inhibits binding to5-HT₃, 5-HT_(4C), and Ne (Norepinephrine) uptake receptors. It was alsofound that the essentially pure diastereoiosomer,(3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, inhibits binding to5-HT₇, 5-HT_(2c), and Ne uptake receptors. It was also found that theessentially pure diastereoiosomer,(3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, inhibits binding to5-HT_(1A) and 5-HT₇ receptors. The difference in receptor bindingbetween diastereomers of ifoxetine is unexpected in view of the resultsof Waldmeier, wherein it was disclosed that the racemic ifoxetine hadminimal activity at 5-HT₁, and 5-HT₂ receptors at concentrations of 10μM of the racemate.

% inhibition of Assay control specific binding Compound at 100 nM conc.5-HT_(1A) 3S, 4R-4-(2,3-dimethylphenyl)-3- 9 hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 39 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- 16 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- −8 hydroxypiperidine 5-HT_(2B) 3S,4R-4-(2,3-dimethylphenyl)-3- 6 hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 48 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- 6 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- 6 hydroxypiperidine 5-HT₃ 3S,4R-4-(2,3-dimethylphenyl)-3- 11 hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 6 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- 4 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- 5 hydroxypiperidine 5-HT_(4C) 3S,4R-4-(2,3-dimethylphenyl)-3- 15 hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 8 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- 0 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- 5 hydroxypiperidine 5-HT₇ 3S,4R-4-(2,3-dimethylphenyl)-3- 6 hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 1 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- 16 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- 22 hydroxypiperidine 5-HT_(2c) 3S,4R-4-(2,3-dimethylphenyl)-3- −17 hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 4 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- −11 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- 7 hydroxypiperidine NE uptake 3S,4R-4-(2,3-dimethylphenyl)- 8 3-hydroxypiperidine 3R,4S-4-(2,3-dimethylphenyl)-3- 3 hydroxypiperidine 3R,4R-4-(2,3-dimethylphenyl)- −9 3-hydroxypiperidine 3S,4S-4-(2,3-dimethylphenyl)-3- 4 hydroxypiperidine

5-HT receptor binding assays were performed according to the method wellknown in the art. See for example Mulerhorn et al. J. Biol. Chem. 269(1994) 12954-12962, Bonhaus et al. (1995) et al. J. Biol. Chem. 269(1994) 12954-12962 herein incorporated by reference in its entirety. Seealso U.S. Pat. Nos. 5,126,363; 5,688,807; 5,786,157; and 5,869,691herein incorporated by reference in their entirety.

Briefly, CHO cells expressing human 5-HT receptor subtypes, or membranesprepared therefrom, were incubated with a specific radioactive ligandfor 60 minutes at 22° C. (0.5 nM of [³H]-8-OH-DPAT for 5-HT_(1A)receptors, 1.2 nM of [³H]-LSD for 5-HT_(2B) receptors). Incubations wereperformed in the presence or absence of one of the followingdiastereomers: 10 μM 8-OH-DPAT; 100 nM(3S,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine; 100 nM(3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine; 100 nM(3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine; 100 nM(3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine. Following incubationthe cells or membranes were washed recovered and the radioactivitycontent of the filter used to determine specific receptor binding andinhibition by the essential pure diastereomers.

Composition Comprising Essentially Purified Diastereomers of4-aryloxy-3-hydroxypiperidines

In a further embodiment the present invention provides for apharmaceutical compositions which comprise a pharmaceutically acceptablecarrier and an effective amount of an essentially pure diastereomer of a4-aryloxy-3-hydroxypiperidine (1) or an addition salt thereof,

where Ar is a substituted or unsubstituted aromatic hydrocarbon groupand R is hydrogen or methyl, carbon 3 is either in the R or the Sconfiguration and carbon 4 is either in the R or the S configuration anda pharmaceutically acceptable carrier.

As used herein, an effective amount of an essentially pure diastereomermay refer to low dosages for some disorders and high dosages for otherdisorders. Preferably, an effective amount refers to a dosage of about0.1 mg to about 800 mg.

Preferably, the composition is administered about 1 to about 4 times aday. More preferably, the composition is administered about 1 to about 2times a day. Most preferably, the composition is administered once aday.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure (3R,4S),-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition salt thereofand a pharmaceutically acceptable carrier.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure (3S,4R),-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition salt thereofand a pharmaceutically acceptable carrier.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure(3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition saltthereof and a pharmaceutically acceptable carrier.

In a further embodiment the present invention provides for apharmaceutical composition comprising essentially pure(3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition saltthereof and a pharmaceutically acceptable carrier.

It is provided that the essentially purified diastereomers of4-aryloxy-3-hydroxypiperidines of the invention may be administered as apurified compound. Preferably, however, the essentially purifieddiastereomer of 4-aryloxy-3-hydroxypiperidine will be administered as apharmaceutical composition with a pharmaceutically acceptable carrier.It is provided that the essentially purified diastereomer of4-aryloxy-3-hydroxypiperidines of the invention may be administered inany suitable manner, for example, in the form of a tablet, capsule,liquid (e.g. syrup) or by injection, including orally, parenterally(including subcutaneously, intramuscularly and intravenously), ortopically.

The present invention provides for a pharmaceutical compositioncomprising a pharmaceutically acceptable carrier and, as an activeingredient, an effective amount of an essentially purified diastereomerof 4-aryloxy-3-hydroxypiperidines of compound 1 or pharmaceuticallyacceptable salt thereof. Preferably the essentially purifieddiastereomer is a diastereomer of compounds 2 to 5 or pharmaceuticallyacceptable salt thereof. Most preferably the essentially purifieddiastereomer is (3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine,(3S,4R), -4-(2,3-dimethylphenyl)-3-hydroxypiperidine,(3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, or(3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine.

The effective amount of essentially purified diastereomers of4-aryloxy-3-hydroxypiperidines will of course vary and is ultimately atthe discretion of the medical or veterinary practitioner in eachparticular case. The factors to be considered by such a practitioner,e.g. a physician, include the route of administration and pharmaceuticalformulation; the subject's body weight, surface area, age and generalcondition; and the chemical form of the compound to be administered.

It is contemplated that the essentially purified diastereomers of4-aryloxy-3-hydroxypiperidines may be given as a single dose, multipledoses, or by intravenous infusion for any selected duration.

The essentially purified diastereomers of the4-aryloxy-3-hydroxypiperidine may be formulated into a variety ofpharmaceutical compositions and dosage forms that are useful in treatingpatients.

Pharmaceutical compositions of the present invention contain theessentially purified diastereomer of the 4-aryloxy-3-hydroxypiperidineas an active ingredient. In addition to the active ingredient(s), thepharmaceutical compositions of the present invention may contain one ormore excipients. Excipients are added to the composition for a varietyof purposes.

Diluents increase the bulk of a solid pharmaceutical composition and maymake a pharmaceutical dosage form containing the composition easier forthe patient and caregiver to handle. Diluents for solid compositionsinclude, for example, microcrystalline cellulose (e.g. AVICEL7,microfine cellulose, lactose, starch, pregelitinized starch, calciumcarbonate, calcium sulfate, sugar, dextrates, dextrin, dextrose, dibasiccalcium phosphate dihydrate, tribasic calcium phosphate, kaolin,magnesium carbonate, magnesium oxide, maltodextrin, mannitol,polymethacrylates (e.g. Eudragit7), potassium chloride, powderedcellulose, sodium chloride, sorbitol and talc.

Solid pharmaceutical compositions that are compacted into a dosage formlike a tablet may include excipients whose functions include helping tobind the active ingredient and other excipients together aftercompression. Binders for solid pharmaceutical compositions includeacacia, alginic acid, carbomer (e.g. carbopol), carboxymethylcellulosesodium, dextrin, ethyl cellulose, gelatin, guar gum, hydrogenatedvegetable oil, hydroxyethyl cellulose, hydroxypropyl cellulose (e.g.KLUCEL7), hydroxypropyl methyl cellulose (e.g. METHOCEL7), liquidglucose, magnesium aluminum silicate, maltodextrin, methylcellulose,polymethacrylates, povidone (e.g. KOLLIDON7, PLASDONE7), pregelatinizedstarch, sodium alginate and starch.

The dissolution rate of a compacted solid pharmaceutical composition inthe patient's stomach may be increased by the addition of a disintegrantto the composition. Disintegrants include alginic acid,carboxymethylcellulose calcium, carboxymethylcellulose sodium (e.g.Ac-DI-SOL7, PRIMELLOSE7), colloidal silicon dioxide, croscarmellosesodium, crospovidone (e.g. KOLLIDON7, POLYPLASDONE7), guar gum,magnesium aluminum silicate, methyl cellulose, microcrystallinecellulose, polacrilin potassium, powdered cellulose, pregelatinizedstarch, sodium alginate, sodium starch glycolate (e.g. EXPLOTAB7) andstarch.

Glidants can be added to improve the flow properties of non-compactedsolid compositions and improve the accuracy of dosing. Excipients thatmay function as glidants include colloidal silicon dixoide, magnesiumtrisilicate, powdered cellulose, starch, talc and tribasic calciumphosphate.

When a dosage form such as a tablet is made by compaction of a powderedcomposition, the composition is subjected to pressure from a punch anddye. Some excipients and active ingredients have a tendency to adhere tothe surfaces of the punch and dye, which can cause the product to havepitting and other surface irregularities. A lubricant can be added tothe composition to reduce adhesion and ease release of the product fromthe dye. Lubricants include magnesium stearate, calcium stearate,glyceryl monostearate, glyceryl palmitostearate, hydrogenated castoroil, hydrogenated vegetable oil, mineral oil, polyethylene glycol,sodium benzoate, sodium lauryl sulfate, sodium stearyl famarate, stearicacid, talc and zinc stearate.

Flavoring agents and flavor enhancers make the dosage form morepalatable to the patient. Common flavoring agents and flavor enhancersfor pharmaceutical products that may be included in the composition ofthe present invention include maltol, vanillin, ethyl vanillin, menthol,citric acid, fumaric acid ethyl maltol, and tartaric acid.

Compositions may also be colored using any pharmaceutically acceptablecolorant to improve their appearance and/or facilitate patientidentification of the product and unit dosage level.

Selection of excipients and the amounts to use may be readily determinedby the formulation scientist based upon experience and consideration ofstandard procedures and reference work in the field.

The solid compositions of the present invention include powders,granulates, aggregates and compacted compositions. The dosages includedosages suitable for oral, buccal, sublingual rectal, parenteral(including subcutaneous, intramuscular, and intravenous), inhalant andophthalmic administration also and via nasal spray. Although the mostsuitable route in any given case will depend on the nature and severityof the condition being treated, the most preferred route of the presentinvention is oral. The dosages may be conveniently presented in unitdosage form and prepared by any of the methods well-known in thepharmaceutical arts.

Dosage forms include solid dosage forms like tablets, powders, capsules,suppositories, sachets, troches, fast dissolving preparations andlozenges as well as liquid syrups, suspensions and elixirs. Anespecially preferred dosage form of the present invention is a tablet.

Such pharmaceutical compositions for medical use will be formulated inaccordance with any of the methods well known in the art of pharmacy foradministration in any convenient manner. The compounds of the inventionwill usually be admixed with at least one other ingredient providing acompatible pharmaceutically acceptable additive, carrier, diluent orexcipient, and may be presented in unit dosage form.

The carrier(s) must be pharmaceutically acceptable in the sense of beingcompatible with the other ingredients of the formulation and notdeleterious to the recipient thereof.

The possible formulations include those suitable for oral, rectal,topical and parenteral (including subcutaneous, intramuscular andintravenous) administration or for administration to the lung or anotherabsorptive site such as the nasal passages.

All methods of formulation in making up such pharmaceutical compositionswill generally include the step of bringing the diastereomer ofcompounds 2 to 5 into association with a carrier which constitutes oneor more accessory ingredients. Usually, the formulations are prepared byuniformly and intimately bringing the essentially purified diastereomerof compounds 2 to 5 into association with a liquid carrier or with afinely divided solid carrier or with both and then, if necessary,shaping the product into desired formulations.

Formulations of the present invention suitable for oral administrationmay be presented as discrete units such as capsules, cachets, tablets orlozenges, each containing a predetermined amount of the essentiallypurified diastereomer of compounds 2 to 5; as a powder or granules; or asuspension in an aqueous liquid or non-aqueous liquid such as a syrup,an elixir, an emulsion or a draught. The essentially purifieddiastereomer of compounds 2 to 5 may also be presented as a bolus,electuary or paste.

A tablet may be made by compression or moulding, optionally with one ormore accessory ingredients. Compressed tablets may be prepared bycompressing, in a suitable machine, the essentially purifieddiastereomer of compounds 2 to 5 in a free-flowing form such as a powderor granules, optionally mixed with a binder, lubricant, inert diluent,surface active or dispersing agent. Moulded tablets may be made bymoulding, in a suitable machine, a mixture of the powdered essentiallypurified diastereomer of compounds 2 to 5 with any suitable carrier.

A syrup may be made by adding the essentially purified diastereomer ofcompounds 2 to 5 to a concentrated, aqueous solution of a sugar, forexample sucrose, to which may be added any desired accessory ingredient.Such accessory ingredient(s) may include flavourings, an agent to retardcrystallisation of the sugar or an agent to increase the solubility ofany other ingredient, such as a polyhydric alcohol, for example glycerolor sorbitol.

Formulations for rectal administration may be presented as a suppositorywith a usual carrier such as cocoa butter.

Formulations suitable for parental administration conveniently comprisea sterile aqueous preparation of the essentially purified diastereomerof compounds 2 to 5 which is preferably isotonic with the blood of therecipient.

In addition to the aforementioned ingredients, formulations of thisinvention, for example ointments, creams and the like, may include oneor more accessory ingredients, for example a diluent, buffer, flavouringagent, binder, surface active agent, thickener, lubricant and/or apreservative (including an antioxidant) or other pharmaceutically inertexcipient.

The compounds of this invention may also administered as a liposomalformulation which can be prepared by methods well-known in the art. Seefor example U.S. Pat. Nos. 5,446,070, 5,891,465, 5,759,573, 5,997,899,and 5,962,016, each of which is incorporated by reference in itsentirety.

The function and advantage of these and other embodiments of the presentinvention will be more fully understood from the examples below. Thefollowing examples are intended to illustrate the benefits of thepresent invention, but do not exemplify the full scope of the invention.

EXAMPLES Example 1 Preparation 1 of trans-racemic4-(2,3-dimethylphenoxy)-3-hydroxypiperidine

Step 1. A stirred solution of benzyl3,6-dihydropyridine-1(2H)-carboxylate (20.0 g, 92.0 mmol) indichloromethane (280 ml) was cooled to 0° C. A solution ofm-chloroperoxybenzoic acid (22.5 g, approx. 130 mmol) in dichloromethane(560 ml) was added drop-wise and the resulting colourless reactionmixture warmed to room temperature. After an additional 4 h at roomtemperature (reaction complete by tlc using 50:50 hexane:ethyl acetateas eluent.) the reaction mixture was washed with aqueous potassiumcarbonate solution (5 wt %, 3×200 ml) and brine (200 ml). The organiclayer was dried over anhydrous magnesium sulfate, filtered andconcentrated in vacuo to furnish benzyl7-oxa-3-azabicyclo[4.1.0]heptane-3-carboxylate as a yellow oil (22.0 g;100%).

Step 2. Benzyl 7-oxa-3-azabicyclo[4.1.0]heptane-3-carboxylate (21.0 g,92.0 mmol) was added to a stirred solution of 2,3-dimethylphenol (23.0g, 188 mmol) and aqueous sodium hydroxide (100 ml, 2N, 200 mmol) inacetonitrile (400 ml). The reaction mixture was heated at reflux for 14h. On cooling to room temperature, the reaction mixture was concentratedin vacuo before dilution with water (500 ml). Extraction withdichloromethane (4×100 ml) was followed by washing of the combinedorganics with aqueous sodium hydroxide (100 ml, 3N, 300 mmol), water(100 ml) and brine (100 ml). The organics were dried over anhydrousmagnesium sulfate, filtered and concentrated in vacuo to furnish a crudeproduct. Purification was carried out by silica gel chromatography usinga gradient eluent system of iso-hexanes and ethyl acetate (100%iso-hexanes to 80:20 iso-hexanes:ethyl acetate) to furnishtrans-benzyl-4-(2,3-dimethylphenoxy)-3-hydroxypiperidine-1-carboxylateas a pale yellow syrup (16.8 g, 50%).

Step 3. A solution of trans-benzyl4-(2,3-dimethylphenoxy)-3-hydroxypiperidine-1-carboxylate (3.5 g, 9.8mmol) in methanol (50 ml) was added to 5% palladium on charcoal (350 mg)under an atmosphere of nitrogen. The vessel was placed under anatmosphere of hydrogen and stirred vigorously until hydrogen uptakeceased. The resulting suspension was filtered over a short pad of celite(pre-washed with methanol) and the pad washed with a further portion ofmethanol (100 ml). Concentration of the methanolic solution in vacuogave a yellow oil. Dilution with diethyl ether (100 ml) yieldedtrans-4-(2,3-dimethylphenoxy)-3-hydroxypiperidine as a white solid (1.01g, 50%).

Example 2 Preparation 2 of cis-racemic4-(2,3-dimethylphenoxy)-3-hydroxypiperidine

Step 1. A solution of oxalyl chloride (3.5 ml, 40 mmol, 1.1 eq.) indichloromethane (350 ml) was cooled to −60° C. (internal temp.) andtreated drop-wise with dimethyl sulfoxide (5.18 ml, 73.0 mmol, 2 eq.).On completion of addition the reaction mixture was stirred at −60° C.for 5 min. before drop-wise addition of a solution oftrans-benzyl-4-(2,3-dimethylphenoxy)-3-hydroxypiperidine-1-carboxylate(13.0 g, 36.5 mmol) in dichloromethane (50 ml). After 30 min.triethylamine (15.5 ml, 110 mmol, 3.0 eq.) was added drop-wise and thesolution stirred at −60° C. for 10 min, before allowing the mixture towarm slowly to room temperature. After 18 h. the reaction mixture wasdiluted with water (400 ml) and the resultant biphasic system separated.The aqueous layer was extracted with dichloromethane (400 ml). Combinedorganics were washed with aqueous hydrochloric acid (200 ml, 0.1N),dried over anhydrous magnesium sulfate, filtered and concentrated invacuo to furnish benzyl4-(2,3-dimethylphenoxy)-3-oxopiperidine-1-carboxylate as a pale yellowamorphous solid (12.8 g, 99%).

Step 2. A solution of benzyl4-(2,3-dimethylphenoxy)-3-oxopiperidine-1-carboxylate (10.0 g, 28.0mmol) in tetrahydrofuran (60 ml) was treated at room temperature withK-selectride (10.0M in tetrahydrofuran, 56 ml, 56.0 mmol). On completionof addition the mixture was stirred at room temperature for 18 h. Themixture was concentrated to dryness in vacuo and diluted carefully byaddition of ice-water (100 ml). Extraction with dichloromethane (2×200ml) was followed by washing the combined organics with aqueoushydrochloric acid (100 ml, 0.1N), water (100 ml) and brine (100 ml). Theorganics were dried over anhydrous magnesium sulfate, filtered andconcentrated in vacuo to give a dark oil which was purified by silicagel chromatography using isohexanes:ethyl acetate (5:1) as eluent tofurnish cis-benzyl4-(2,3-dimethylphenoxy)-3-hydroxypiperidine-1-carboxylate as a paleyellow syrup (5.01 g, 50%).

Step 3. A solution of cis-benzyl4-(2,3-dimethylphenoxy)-3-hydroxypiperidine-1-carboxylate (5.0 g, 14.0mmol) in methanol (60 ml) was added to 5% palladium on charcoal (500 mg)under an atmosphere of nitrogen. The vessel was placed under anatmosphere of hydrogen and stirred vigorously until hydrogen uptakeceased. The resulting suspension was filtered over a short pad of celite(pre-washed with methanol) and the pad washed with a further portion ofmethanol (150 ml). Concentration of the methanolic solution in vacuogave a yellow oil. Dilution with diethyl ether (150 ml) yieldedcis-4-(2,3-dimethylphenoxy)-3-hydroxypiperidine as a white solid (2.1 g,67%).

Example 3 Purification of Stereoisomers of4-(2,3-dimethylphenoxy)-3-hydroxypiperidine

A solution of cis 4-(2,3-dimethylphenoxy)-3-hydroxypiperidine wasprepared at a concentration of 0.5 mg/ml in HPLC grade ethanol;sonication for at least 10 min was required to ensure completedissolution. Separation was carried out using the following parameters:

Column Chiralpak AD 250 × 4.6 mm 5μ Column Temperature ambient Flow 0.5ml/min Injection Volume 10 μl Wavelength Range 254 nm Mobile Phase HPLCethanol Run time 20 min

The procedure was repeated fortrans-(2,3-dimethylphenoxy)-3-hydroxypiperidine. The trans isomerrequired sonication for 10 minutes prior to HPLC purification.

Retention times were as follows: 3S,4R-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 8.3 minutes; 3R,4S-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 10.7 minutes; 3R,4R-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 8.9 minutes; and nM 3S,4S-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 10.7 minutes. Theidentification of each compound was made by optical rotation.

Example 4 Preperative Purification of Stereoisomers of4-(2,3-dimethylphenoxy)-3-hydroxypiperidine

A solution of cis 4-(2,3-dimethylphenoxy)-3-hydroxypiperidine wasprepared at a concentration of 0.5 mg/ml in HPLC grade ethanol;sonication for at least 10 min was required to ensure completedissolution. Separation was carried out using the following parameters:

Column Chiralpak AD 250 × 20.00 mm 10μ Column Temperature ambient Flow 5ml/min Injection Volume 1000 μl Wavelength Range 254 nm Mobile PhaseHPLC ethanol Run time 20 min. (please confirm) Wash Solvent Hexane/IPA90:10

The procedure was repeated fortrans-(2,3-dimethylphenoxy)-3-hydroxypiperidine. The trans isomerrequired sonication for 10 minutes prior to HPLC purification.

Retention times were as follows:(3S,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 14.5 minutes;(3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 16.5 minutes;(3R,4R)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 15 minutes; and nM(3S,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, 17 minutes. Theidentification of each compound was made by optical rotation.

1. An essentially pure diastereomer of a 4-aryloxy-3-hydroxypiperidine(1) or an addition salt thereof,

wherein the diastereomer is in the (3R,4S) configuration, Ar is selectedfrom a group consisting of 2,3-dimethylphenyl and 3,4-dimethylphenyl, Ris selected from a group consisting of hydrogen and methyl, and thediastereomer is greater than about 90% purified from other isomers offormula
 1. 2. The diastereomer of claim 1, wherein the diastereomer isgreater than about 95% purified from other isomers of formula
 1. 3. Thediastereomer of claim 1, wherein the diastereomer is greater than about98% purified from other isomers of formula
 1. 4. An essentially purediastereomer of 4-(2,3-dimethylphenyl)-3-hydroxypiperidine or anaddition salt thereof, wherein the diastereomer is(3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, and the diastereomeris greater than about 90% purified from other isomers of4-(2,3-dimethylphenyl)-3-hydroxypiperidine.
 5. The diastereomer of claim4, wherein the diastereomer is greater than about 95% purified fromother isomers of 4-(2,3-dimethylphenyl)-3-hydroxypiperidine.
 6. Thediastereomer of claim 4, wherein the diastereomer is greater than about98% purified from other isomers of4-(2,3-dimethylphenyl)-3-hydroxypiperidine.
 7. A pharmaceuticalcomposition, comprising a pharmaceutically acceptable carrier and aneffective amount of an essentially pure diastereomer of a4-aryloxy-3-hydroxypiperidine (1) or an addition salt thereof.

wherein the diastereomer is in the (3R,4S) configuration, Ar is selectedfrom a group consisting of 2,3-dimethylphenyl and 3,4-dimethylphenyl, Ris selected from a group consisting of hydrogen and methyl, and thediastereomer is greater than about 90% purified from other isomers offormula
 1. 8. The diastereomer of claim 7, wherein the diastereomer isgreater than about 95% purified from other isomers of formula
 1. 9. Thediastereomer of claim 7, wherein the diastereomer is greater than about98% purified from other isomers of formula
 1. 10. The pharmaceuticalcomposition of claim 7, wherein the composition is in a form foradministration as a tablet, a capsule, a liquid or an injection.
 11. Apharmaceutical composition, comprising a pharmaceutically acceptablecarrier and an effective amount of an essentially pure diastereomer of4-(2,3-dimethylphenyl)-3-hydroxypiperidine or an addition salt thereof,wherein the diastereomer is(3R,4S)-4-(2,3-dimethylphenyl)-3-hydroxypiperidine, and the diastereomeris greater than about 90% purified from other isomers of4-(2,3dimethylphenyl)-3-hydroxypiperidine.
 12. The diastereomer of claim11, wherein the diastereomer is greater than about 95% purified fromother isomers of 4-(2,3-dimethylphenyl)-3-hydroxypiperidine.
 13. Thediastereomer of claim 11, wherein the diastereomer is greater than about98% purified from other isomers of4-(2,3-dimethylphenyl)-3-hydroxypiperidine.
 14. The pharmaceuticalcomposition of claim 11, wherein the composition is in a form foradministration as a tablet, a capsule, a liquid or an injection.